Deciding how much to pay support staff can be tricky. If you overpay them, you let money walk out the door. Underpay and you risk high turnover, which could end up costing you even more.

The sad state of the economy complicates things further. If your practice is seeing some softening as patients lose jobs and health insurance, you may be looking for ways to belt-tighten. And now would seem to be the time to save on staff costs: With jobs scarce, workers are less likely to bolt. But the economy won’t be in recession forever, and when it returns to normalcy you don’t want to be seen as the employer who took advantage of people when they were down.

So, with all of that said: How do you decide what the right number is?

FIND OUT MORE
Motivating staff without money
Speed training
Easy vacation scheduling

For more granularity, review our data broken down by region (Mid-Atlantic, Northeast, North-Central, Southeast, South-Central, Southwest, Rockies, and West), and summarized into one comprehensive spreadsheet.

Bucks, clams, and greenbacks

We found wide disparities in pay based on region, and on whether the practice is in an urban, suburban, or rural setting. In the South Central states, for example, private-office nurses make $58,941.52 annually while in the Southwest they can expect to make only $47,736.

Urban areas tend to pay higher than suburbs and rural locations, reflecting cost-of-living differences. But rural practices generally have a thinner pool of qualified applicants from which to choose, and that can force them to keep salaries higher than they might like. Doug Bishoff, president of Memorial Clinic in Moorefield, W.V., says that even though the clinic is in a mainly rural area, larger markets are close enough that he has to keep his salaries competitive.

“I look at two or three different areas to determine wages — I can’t just look at rural numbers, urban areas, or even suburban areas. We’re all those and it’s a real mix here,” says Bishoff. “We’re fairly close to [Washington] D.C., and it’s hard to determine wages sometimes. People can say, ‘Well I can drive 50 or 60 miles and make more money.’ But do they really want to do that?”

Sometimes the best way to get a handle on what to pay for a given position is to simply ask job candidates about their salary expectations. “I always ask in reviews or interviews what a [candidate] is worth and they say, ‘What?’” says Jeff Carroll, administrator of Kalamazoo Gastroenterology & Hepatology, in Michigan. “It usually catches them by surprise.”

But Anna McCoy, practice manager of Vascular & General Surgery Associates in New Braunfels, Texas, is less interested in what job prospects think they should make than in what they have been making. “I expect any employee who comes to me is expecting to do as well or a little more” as they had been, says McCoy. So she asks. Questions about salary history and expectations, though, are commonplace and shouldn’t surprise most job candidates.

One of the most important salary determinants is experience. The more a person has, the more he tends to make, naturally. But in medical practices, there are many positions for which the benefits of experience are limited. “Experience will always matter, but every job has a value. You look at a front-desk employee averaging $13 an hour. If they’ve been there for 20 years, they can’t expect to make $20 an hour,” says practice consultant Owen Dahl. “They’ll either freeze at a level or be gone.”

But many practices prefer all employees to have at least some know-how right off the bat. McCoy says experience is important, even for lower-rung jobs, at her two-physician practice, due to the nature of its specialty.

“It’s a general surgery and vascular surgery practice, and anyone who steps in our door needs to at least have some terminology and needs to know how things run in our area,” she says.

But, she admits her rural Texas location isn’t always bursting with well-seasoned candidates, so sometimes they have to look more for potential. And that’s worked out, too, she says. “I hired a 23-year-old who worked at the hospital and we’ve been really happy with her,” says McCoy. “The doctor she works with is so easygoing and doesn’t mind teaching. We’ve been lucky.”